Provider Demographics
NPI:1902216336
Name:LOPPATTO, TRACY (LGPC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:LOPPATTO
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8910
Mailing Address - Country:US
Mailing Address - Phone:410-491-5728
Mailing Address - Fax:
Practice Address - Street 1:1051 HARBOR CT
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-8910
Practice Address - Country:US
Practice Address - Phone:410-491-5728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP5415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional